Am I going crazy?

July 22, 2006 7:11 AM

Recently, I've been having problems figuring out what's real and what's not.

The past two weeks or so, I'll be going along fine and all of a sudden, I'll wonder if what just happened was real or imagined. Memories have that "feeling" that they're not real. Kinda' like how you remember a dream.

I don't have a diagnosis of schizophrenia or anything, but I do have a diagnosis of severe depressive episodes that's being medicated with Prozac 40mg, once daily. I've been on that regimine for almost 4 years now.

My question is, what's a surefire way to tell if what you're experiencing is real or not? How do we know we're not in a coma (or other similar situation) *right now* and we're just dreaming this?

posted by drleary to health (34 comments total)

I can't answer your question, but I had similar feelings when I was deeply depressed a few years back. An odd sensation for sure, but it went away eventually. I felt it in socially stressfull situations. I just made sure I was actively engaged in life, creatively, socially and otherwise.

Hang in there drleary.
posted by punkfloyd at 7:18 AM on July 22, 2006

Question: How old are you?
posted by thebrokedown at 7:19 AM on July 22, 2006

thebrokedown: 23

punkfloyd: My depression has been mostly controlled. When I'm feeling *really* down though, I have a prescription for Xanax 2mg, but I rarely take it because it knocks me out for like 2 days.
posted by drleary at 7:22 AM on July 22, 2006

As far as knowing that things are real, as opposed to your actually being in a dream, etc.--philosophically, does it really even matter? My attitude is to always behave as if what you're experiencing is the real thing. Just simpler that way.
posted by thebrokedown at 7:24 AM on July 22, 2006

Have you had therapy? Can you afford it? I'd strongly recommend talking through this stuff with someone who knows how to lead you.

There is no answer to how most people know what they're experiencing is real. That's a baseline perception; it isn't built out of anything. If you lose it, you definitely want to get it back.
posted by argybarg at 7:32 AM on July 22, 2006

I've heard that you can't see what time it is in dreams. So if you can look at a clock and read it, you're awake. Also, if you open a book (or find a webpage) of limericks and read one at random, then you're awake because your mind could not conceive of something like that instantaneously. Granted these are just tricks and tales, but if they help you out (before you get a chance to discuss this with a therapist, which I really think you should do), then why the hell not.
posted by unknowncommand at 7:51 AM on July 22, 2006 [1 favorite]

IANAD, but it sounds like it could be schizophrenia. There is a type of the disease where you cannot distinguish dreams from reality, so things that happen to you sometimes seem like they are really not happening, like you will just wake up from it, and vice versa.

Go to your doctor and tell her or him exactly what you have posted here, and do it soon.

Good luck.
posted by 4ster at 8:00 AM on July 22, 2006

If you have this kind of experience when you are with someone you trust, ask them if what just happened actually happened.

Given that you are on a medication regimen I assume that you have a prescribing physician. If this doctor is not a psychiatrist I would encourage you to get a referral and at least have a consultation with a psychiatrist. You are at an age when a variety of mental illnesses tend to develop in those prone to them (schizophrenia, manic depression). Is there a history of mental illness in your family?

I hope you find health and peace of mind.
posted by persona non grata at 8:07 AM on July 22, 2006

This isn't really an answer to your question, but is it something that lasts a while or is it just temporary confusion? I get temporarily confused sometimes and even believe some really outlandish dreams happened the last couple days, but the sense of it being real diminishes after a while. The number of occurrences have increased lately as I have had a lot of depression, but they are still only temporary.

I don't consider it much of a problem. I always just attributed it to my mind being so obsessed with the depression that sometimes it didn't care to distinguish between what else was going on. When the depression eases the symptoms go away.
posted by Hypharse at 8:28 AM on July 22, 2006

I heard that you cannot see yourself in a dream. So, raise your arm and look at it. If you can do that, you are living large, if not, dream on.
posted by JohnnyGunn at 8:36 AM on July 22, 2006

In "Consciousness Explained," Daniel Dennett tackles the Brain in a Vat paradox -- which claims we can't know whether or not we're experiencing reality, because we could just be a brain (in a vat of chemicals) hooked up to sensory apparatus that feeds in fake inputs.

Dennett says the vat is impossible -- or at least highly unlikely -- because it would take an unimaginable amount of computing power to fake reality on the detailed level we generally experience. As an example, he mentions running your fingers through sand. You can feel each individual grain. No simulation (or hallucination) can re-create this. (Which also means sci-fi staples, like the Holodeck, are nonsensical.)

If Dennett is right, your brain also can't compute such simulations. It MUST be aided by real-world inputs. My guess is that hallucinations convince people, because when you experience them, you're too emotional to notice the lack of details. (You also might be experiencing a mixture of reality and hallucination -- the sand might be real, but the talking crab might not.)

Cartoons prove that we're WILLING to accept illusions that are not as detailed as the real world, and our default assumption will generally be that what we're sensing is real. But if you really LOOK at a cartoon, you quickly notice the missing bits, and you know it's fake.

So perhaps you can do the same thing. If you're wondering whether or not you're experiencing real life, try testing it on a really MUNDANE detailed level: can you see the dots of ink in newsprint? The individual pixels on a screen? Can you pour sugar on your tongue and feel/taste each grain? Can you touch each one of your teeth and feel how they are different from one another? If so, I'd say you're experiencing reality.
posted by grumblebee at 8:53 AM on July 22, 2006 [2 favorites]

I think he is talking about remembering things, not wondering if he is in reality right that minute.

Sounds like a weird variant of deja vu...anyway, I'd run that past the doc. It could be a form of disassociation. Or it could be a side effect from your med. A professional should be able to figure it out for you.
posted by konolia at 9:22 AM on July 22, 2006

drleary, is that your name because of any trippy chemicals you may have ingested? If so I would lay off. These things tend go away when chemically induced, although it could take a few years.

Alternatively, have you been overly stressed out lately? Have you been missing lots of sleep? Stress and fatigue can definitely lead to these feelings.

Of course, it could be your meds. You really should talk to your doctor.
posted by caddis at 9:29 AM on July 22, 2006

I guess that if I was talking to a friend who expressed this thought I would want to question them more about the particular circumstances of these feelings that have arisen in the last couple of weeks.

Things like: when?, where?, stress?, missed meds/food/sleep?, repercussions (if any)?, associated phenomena like aural/visual disturbances or headaches? and the somesuch.

But you have specifically asked for surefire 'awakeness' measures as your final point so I suppose I will draw the conclusion (possibly erroneously) that these feelings have not been interfering with your life to an extent beyond your simply musing about the subject. In which case I guess I would probably try and do a few things, some mentioned above such as: looking at the time, tasting something, pinching yourself, asking someone what the time is ----- and I would have a little bit of concern if more than one of these checks was particularly unusual for some reason, in which case I would want to see the prozac prescriber.

I would probably advise my friend to see the prozac prescriber anyway.
posted by peacay at 10:05 AM on July 22, 2006

IANAD, or a therapist, but my brother is a schizophrenic, and I take care of him. I've also known a couple of other schizophrenics for many years, and some bipolar folks, too. I've had a few hallucinations myself, as most normal folks do at some point in life (mine have mostly been predictable side effects of sleep deprivation, showing up after from 72 to 80 hours of wake time, like clockwork, or symptoms of migraine headaches). What the OP described doesn't sound like hallucinations or psychosis to me.

For drleary and those of you like grumblebee who are suggesting mechanisms for drleary to check his mental function in response to his questions, all I can say is, that there is generally a clear functional difference between the kinds of "memory errors" and reality confusions I think drleary is discussing, and those that cause schizophrenics such problems. The schizophrenic not only hears sounds that don't exist (visual hallucinations being pretty rare, despite the A Beautiful Mind movie view of the disease), but experiences these hallucinations combined with a compulsion to believe that they are real, and often, a terrible anxiety about what they are experiencing. The compulsive aspect of the disease makes running the kinds of mental diagnostics grumblebee suggests impossible for most schizophrenics; indeed, the thing that made John Nash's remission of the disease, as chronicled in the movie, so remarkable is precisely that he has, so he says, managed to "reason" himself out of the grip of the condition, without reliance on anti-psychotic medications. But his case is so far from normal in other ways, that it can be no good model for suggestion to others, much as anyone concerned with schizophrenia is very happy for him and his family.

That said, what I think is useful to understand is that the so called paranoid schizophrenic is truly miserably afraid, much of the time, because of the combination of compulsive and anxiety producing aspects of what he experiences, but even those with other manifestations of the disease are often quite anxious or agitated by an experience of reality that is both compelling and surreal. The elements of compulsion to believe and the overriding anxiety that mark true psychosis do not seem present in what drleary relates.

I would second konolia's suggestion at this point, and even call this a form of presque vu. I agree it is something to run past your doc, drleary, pronto, as it could be not so much a side effect of your meds, as a change in your brain's internal chemistry, particularly as relates to serotonin and dopamine levels. Not all SSRI meds remain effective over time, nor do our brain's internal chemistries remain constant with age. As to whether it is the beginning of "going crazy," I wouldn't borrow trouble at this point.

But I would follow this up, fully, frankly and soon, with your psychiatrist.
posted by paulsc at 10:16 AM on July 22, 2006 [1 favorite]

I don't know about anyone else, but I know I'm dreaming when I try to read something, and the words just look like gibberish. In my dream, I usually already know what the words are supposed to say, but I can't actually ever see the letters.

So I would venture to guess that if you can read text, then you're not dreaming.

You might want to do some research on lucid dreaming. I'm sure you'll find more tricks to recognizing when you're in the dream-state and when you're not.
posted by crunchland at 10:45 AM on July 22, 2006

You could be experiencing partial seizures; you're about the right age for adult onset epilepsy, and "weird variant[s] of deja vu" are a very common symptom.

(Epilepsy runs in my family, and I'm currently awaiting an MRI/EEG after experiencing similar symptoms for years).
posted by Freaky at 10:59 AM on July 22, 2006

When I was going through depression and high anxiety levels a few years back I would experience something similar. Not in-the-moment confusion, but "remembering" a conversation with a friend but not really knowing whether I had dreamt it or not. I'd have to ask them a lot of the time. My doctor said it likely had to do with attention span and memory issues tied to the depression and anxiety.

This briefly increased when I went on meds (Effexor XR) but it stopped, and I've been off the meds for a while now and it hasn't come back.

Not much help in telling you why it's happening, but I just wanted you to know that you're not the only one.
posted by aclevername at 11:08 AM on July 22, 2006

I just read about some kind of disorder recently that sounds similar to this. Maybe. Now I can't seem to google it. In the one I'm thinking of, it's more like life seems like a movie that you're watching from the outside, which includes you. It doesn't feel real. Is that the same thing as what you're talking about? I'll keep looking if so. Might be helpful to slap a name on it.
posted by kookoobirdz at 12:00 PM on July 22, 2006

Kookoobirdz, that sounds like a form of disassociation. I even get that at times -just a minute or so at a time, but it's kinda weird.
posted by konolia at 12:03 PM on July 22, 2006

I've had dreams in which I've been able to read, pinch myself and feel it, and come up with new ideas.

grumblebee, if you're a brain in a vat, then you have no idea how much "computing power" might be working on your manufactured reality. You could be the only sentient being in the universe, the simulation could be fueled by the heat of a thousand suns, all the laws of physics that you think you know could be nothing but products of the simulation itself, and the year could be 7615.

drieary, there is no way to know. But most of us are able to keep up a reasonably consistent frame of reference the majority of the time. You should see a psychiatrist and/or a neurologist.
posted by bingo at 12:26 PM on July 22, 2006

thebrokedown: suppose that what's *really happening* is that his 6 year old cousin is offering him a rose... but what he *perceives to be happening* is that a hairy biker is attacking him with a knife?

No, winging it doesn't really seem called for here.
posted by baylink at 12:31 PM on July 22, 2006

Given the severity of your depression, I agree with the posters suggesting you see a psych/specialist about your meds, if you aren't already. This goes double if you've been having issues with sleep, which can really screw around with your memory (a la aclevername's post, which sounds all too familiar).

it's more like life seems like a movie that you're watching from the outside, which includes you. It doesn't feel real.

For the record, when my depression was particularly bad, things felt a lot like this.
posted by Vervain at 12:49 PM on July 22, 2006

Sounds like you're right, konolia. I think what I was reading about before was depersonalization. That's not quite the same as wondering whether something is real or a dream, I guess. Sounds like a cousin though. Depersonalization sounds more like - you know it's real, but you perceive the sensation of it not feeling real.
posted by kookoobirdz at 12:50 PM on July 22, 2006

I've recently read about depersonalization, as well as derealization. I'm wondering if this description of derealization sounds like what you've been experiencing.
posted by wryly at 1:04 PM on July 22, 2006

It's like life is happening on the back burner, and you're somewhere else, mentally, and then all of a sudden, you're not, and what's been going on around you sort of comes into focus, and you wonder if what you're remembering is real? If so, yes, I've been there. Also, psych meds can mess with your sense of reality, sometimes. My email is in my profile if you want to talk.
posted by Meep! Eek! at 2:48 PM on July 22, 2006

Does not sound like schizophrenia to me. Of course, my opinion on that front is worthless.

It does sound like disassociation to me. That's not incredibly well understood, but it also doesn't seem to fit into the lay term of "crazy" for most people that experience it. That would mean that the answer to your question is no: you're not going crazy, if it were indeed disassociation and not something else.

There is not going to be any truly effective way to "prove" that you are awake or that what you see is real. You rely 100% on your mind for such things, and if you really are "crazy" (horrible term), you can't trust what your mind tells you (which leaves aside the problem of what "real" means here, which is irrelevant to your mental health).

This is, in my irrelevant guess, probably not a big deal. Anxiety, depression, Prozac, stress, and normal brain glitches seem like they could create the sensation you describe. But I'd want to run it past a psychiatrist if I were you.
posted by teece at 3:13 PM on July 22, 2006

Severe depression can be accompanied by the sort of psychotic incidents you're describing. There are, of course, other disorders that are more commonly called psychotic disorders, like schizophrenia, but it's not uncommon for people experiencing severe depression to have some psychotic features as well. What you've described does not sound particularly like schizophrenia, but there's really no way to tell without a thorough evaluation.

This isn't a question of the internet, it's a concern to be raised with and addressed by your mental health providers. If a GP is rxing you your prozac it's time to get yourself a psychiatrist.
posted by OmieWise at 4:21 PM on July 22, 2006

I had this a few years ago. It's a very particular feeling and I found it really scary and unpleasant. For me it was about not knowing how long ago something happened, or if I just dreamed it. It's a lot like the feeling of deja vue, but it is also clearly something different. It always made me feel panicky and uncomfortable and sort of gross. What helped me at the time was to sort of "explore" the feeling and not try to run away from it.

I have been more or less depressed on and off since my early teens, (I'm 25 and mostly ok now) I started getting the feeling in my mid teens, when it was fairly obvious that I was depressed, but I wasn't on any medication. I'm now convinced it had a lot to do with sleep patterns, when I started sleeping regularly and for around 8 hours, it stopped. I occasionally get it now if I'm really tired and stressed and I've been sleeping weird hours for a week or so. If I go to bed very late, get up mid morning and have a long nap in the late afternoon for a few days, that will do it.

At the time I had lots of tests as my doctor was worried that it was petit mal epilepsy. They never found anything, although I think they suggested it might be another symptom of the migraines I was also getting at the time (which I don't get anymore).
posted by crabintheocean at 6:35 PM on July 22, 2006

FWIW--for some reason I am quite sure you do not have schizophrenia or other psychotic disorder--depersonalization ot derealiztion are not uncommon phenomena--if they persist or bother you do see a psychiatrist as an adjustment in meds might be indicated--best wishes
posted by rmhsinc at 6:38 PM on July 22, 2006

When ever you wonder if something is real or not, it is real. Everytime. Rest assured that everytime that thought comes up it is real now or was real in the past. The doubt of realness never comes up in dreams or hallucination. The mind's job is to make dreams or hallucination real so the question of realness doesn't ever come up. So welcome the thought of realness as just a friendly reminder that what you question is in fact real. Your doubt proves you are awake and sane. Like they say little doubt little enlightment, big doubt big enlightment.
posted by zackdog at 12:27 AM on July 23, 2006

See a neurologist right away. Your symptoms sound like my seizures. I'd get this strong feeling like I was experiencing moment by moment a dream I had the night before. It was a weird deja vu. I asked by parents about it and they knew nothing. Then one day I came home from college and I started feeling it and I told my mom and bam! I had a grand mal seizure on the spot.

I have temporal lobe epilepsy and this sounds like a temporal lobe problem. Regardless of what it is see a doctor immediately.
posted by Ironmouth at 1:19 AM on July 23, 2006

Seconding the advice about checking your sleep patterns. If you're not currently sleeping regularly and well, your brain will do weird shit to you. Also, check your meds; are you sure your pharmacist hasn't accidentally slipped you a stronger dose? I've used Prozac myself, and I found it a bit dissociative.

As grumblebee says, there is no absolutely surefire, 100% ironclad philosophically guaranteed way to tell reality from illusion; but what I've found works well enough to be going on with are two tests:

1. How often do I feel surprised? Because my mind makes up the entirety of a dream world, surprises tend not to happen.

2. What do my trusted friends say, when I check with them?
posted by flabdablet at 3:35 AM on July 23, 2006

Several posts here mention dissociation, and I am confident this is what you're experiencing. I have suffer from two dissociative disorders--depersonalization and derealization--only recently classified in the DSM-IV.

Dissociation is a natural defense mechanism that any person may experience from time to time without long-term effects, but it can, over time, become one's mind's "preferred" escape from reality, for which reason I strongly agree that you should see a therapist familiar enough with the disorder to help you avoid forming patterns of dissociation. This forum may be helpful in getting some basic questions answered in the meantime if you don't mind wading through some of the (((hugs))) and such.
posted by whoiam at 8:30 AM on July 23, 2006